Provider Demographics
NPI:1750360657
Name:RISHIKOF, DAVID C (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:RISHIKOF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:115 LINCOLN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6358
Mailing Address - Country:US
Mailing Address - Phone:508-383-1525
Mailing Address - Fax:508-383-1570
Practice Address - Street 1:115 LINCOLN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6358
Practice Address - Country:US
Practice Address - Phone:508-383-1525
Practice Address - Fax:508-383-1570
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2011-02-07
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Provider Licenses
StateLicense IDTaxonomies
MA81172207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3193837Medicaid
MAG89177Medicare UPIN
MARIA29214Medicare ID - Type Unspecified